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Adam Black - One of the best experts on this subject based on the ideXlab platform.
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a comparison between independent nurse prescribing and Patient Group Directions in the safety and appropriateness of medication provision in united kingdom sexual health services a mixed methods study
International Journal of Nursing Studies, 2020Co-Authors: Adam Black, Heather Gage, Christine Norton, Bryony Dean Franklin, Trevor Murrells, Molly CourtenayAbstract:Abstract Background United Kingdom legislation allows nurses to autonomously provide medications as independent nurse prescribers or using Patient Group Directions. Evidence of medication safety and appropriateness is limited. We compared nurse prescribers and Patient Group direction users in terms of prevalence, types and severity of medication provision errors. Methods Objectives: Compare safety and appropriateness of medication provision between nurse prescribers and Patient Group direction users. Design: Mixed methods clinical notes review and nurse-Patient consultation observations. Setting Five United Kingdom sexual health services. Selection criteria ‘Clinical notes review’ included a random selection of nurse-Patient consultations July-December 2015, 743 consultations managed by nurse prescribers and 939 consultations by Patient Group direction users. ‘Observation study’ involved 15 nurse prescriber and 15 Patient Group direction user nurse-Patient medication consultations. Patients aged under 16 or non-English speaking were excluded. Measurements Medication safety/appropriateness was compared between nurse prescribers and Patient Group direction users. Medication provision errors were categorised and assigned severity ratings. The Medication Appropriateness Index and the Prescribing Framework were used to assess medication provision. Results Of 1682 clinical notes (nurse prescribers=743, 44%; Patient Group Directions=939, 56%), 879 involved the provision of 1357 medications (nurse prescribers=399, 54%; Patient Group Directions=480, 51%). The overall error rate was 8.5% (1844 errors from a potential 21,738 errors), predominantly related to documentation omissions. Nurse prescribers were more likely to make an error compared to Patient Group Directions users (error rates 9% versus 8%, respectively; p=0.001); most were ‘minor’ (nurse prescribers=489, 56%; Patient Group Directions=602, 62%). Both nurse prescribers and Patient Group direction users made safe medication decisions (n=1640 of 1682 Patient care episodes, 98%); however, Patient Group Directions users worked outside Patient Group Directions restrictions in 39 (8%) of consultations. In 101 consultations, medication was indicated but not documented as offered/provided. From 30 observed consultations assessed against the Prescribing Framework, nurse prescribers’ and Patient Group Directions users’ clinical practice were comparable (maximum score 46: nurse prescribers=44.7; Patient Group direction=45.4, p=0.41). Conclusion Sexual health nurse prescribers and Patient Group direction users provided safe and therapeutically appropriate medication. Improvements in clinical documentation are recommended. Moreover, Patient Group Directions users should be encouraged to adhere to Patient Group Directions’ governance restrictions, such as through regular training, audits and staff updates.
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A comparison between independent nurse prescribing and Patient Group Directions in the safety and appropriateness of medication provision in United Kingdom sexual health services: A mixed methods study.
International Journal of Nursing Studies, 2020Co-Authors: Adam Black, Heather Gage, Christine Norton, Bryony Dean Franklin, Trevor Murrells, Molly CourtenayAbstract:Abstract Background : United Kingdom legislation allows nurses to autonomously provide medications as independent nurse prescribers or using Patient Group Directions. Evidence of medication safety and appropriateness is limited. We compared nurse prescribers and Patient Group direction users in terms of prevalence, types and severity of medication provision errors. Methods : Objectives: Compare safety and appropriateness of medication provision between nurse prescribers and Patient Group direction users Design: Mixed methods: clinical notes review and nurse-Patient consultation observations. Setting: Five United Kingdom sexual health services. Selection criteria: ‘Clinical notes review’ included a random selection of nurse-Patient consultations July-December 2015, 743 consutlations managed by nurse prescribers and 939 consultations by Patient Group direction users. ‘Observation study’ involved 15 nurse prescriber and 15 Patient Group direction user nurse-Patient medication consultations. Patients aged under 16 or non-English speaking were excluded. Measurements: Medication safety/appropriateness was compared between nurse prescribers and Patient Group direction users. Medication provision errors were categorised and assigned severity ratings. The Medication Appropriateness Index and the Prescribing Framework were used to assess medication provision. Results : Of 1,682 clinical notes (nurse prescribers=743, 44%; Patient Group Directions=939, 56%), 879 involved the provision of 1,357 medications (nurse prescribers=399, 54%; Patient Group Directions=480, 51%). The overall error rate was 8.5% (1,844 errors from a potential 21,738 errors), predominantly related to documentation omissions. Nurse prescribers were more likely to make an error compared to Patient Group Directions users (error rates 9% versus 8%, respectively; p=0.001); most were ‘minor’ (nurse prescribers=489, 56%; Patient Group Directions=602, 62%). Both nurse prescribers and Patient Group direction users made safe medication decisions (n=1,640 of 1,682 Patient care episodes, 98%); however, Patient Group Directions users worked outside Patient Group Directions restrictions in 39 (8%) of consultations. In 101 consultations, medication was indicated but not documented as offered/provided. From 30 observed consultations assessed against the Prescribing Framework, nurse prescribers’ and Patient Group Directions users’ clinical practice were comparable (maximum score 46: nurse prescribers=44.7; Patient Group direction=45.4, p=0.41). Conclusion : Sexual health nurse prescribers and Patient Group direction users provided safe and therapeutically appropriate medication. Improvements in clinical documentation are recommended. Moreover, Patient Group Directions users should be encouraged to adhere to Patient Group Directions’ governance restrictions, such as through regular training, audits and staff updates. Contribution of paper What is already known about the topic?
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p118 Patients satisfaction with medication information provided by nurses using independent nurse prescribing inp or Patient Group Directions pgds in uk sexual health services
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Nurses’ ability to independently deliver medication was introduced to improve Patients’ access to medication and experience of healthcare services. INP and PGDs are used frequently in sexual health services; however, there is limited evidence of Patients’ satisfaction with medication information provided. Methods Nurses (INP or using PGD) from five UK sexual health services distributed a questionnaire to Patients with whom they had consulted and delivered medication, Sept 2015 – Aug 2016. The questionnaire was informed by Birmingham’s sexual health service satisfaction questionnaire and the Satisfaction with Information about Medicines Scale (SIMS). Results Of the 393 Patients who received a questionnaire, 92% (n=360) responded. Patients who had received medicines via a PGD and INP reported nurses to be friendly and approachable (n=359/360, 99%); that they installed confidence and trust (n=357/360, 99%); explained the reasons for medications clearly (n=349/360, 97%); and suitably answered questions (n=335/360, 93%). Of the 89% (n=348/360) of respondents who completed the SIMS, an overall score of 13.3/16 was achieved: the higher the score, the greater the satisfaction. The largest points of dissatisfaction related to not receiving information on whether they could drink alcohol (n=58/348, 17%), potential for drowsiness (n=54/348, 16%) or side effects (n=37/348, 11%). Discussion Patients predominantly provided positive feedback regarding their medication consultations with nurses. High SIMS scores identified overall satisfaction with medication information. Further consideration may be needed on the potential problems medications can cause to further improve Patient satisfaction (e.g. advice on alcohol consumption, side effects and drowsiness potential).
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p130 a comparison of demographic characteristics and workloads of independent nurse prescribers inp and nurses using Patient Group Directions pgds in sexual health clinics
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Nurses legally deliver medication independently using INP or PGDs. Despite growing evidence of clinical application, there is limited sexual health research. Methods INP and PGD nurses from five UK sexual health services completed a questionnaire, and recorded two weeks of clinical activity in a specifically designed diary, Aug 2015–Aug 2016. Results Questionnaire response rate: 64% (61/95; INP=26/28, 93%; PGD=35/67, 52%). Respondents were mostly female (n=55/61, 90%), aged 35–44years (n=21/61, 34%). INP were mainly Band 7 or above (n=18/26, 69%), educated to Masters Level (n=16/26, 62%); PGD users were mostly Band 6 (n=24/35, 68.6%), educated to Diploma Level (n=13/35, 37%). INP had mean of 2.9 years more sexual health experience than PGD users (mean: INP=13.0; PGD=10.1years). Both Groups reported access to medications was essential (n=56/61, 92%) and made their roles easier (n=60/61, 98%). Overall 61% (INP=17/26, 65%; PGD=20/35, 57%) of questionnaire respondents completed the diary. Of the total diary entries (INP=737; PGD=593), INP managed more ‘new’ care episodes (n=512/737, 70%) than PGD users (n=294/593, 50%). There was no difference in medication delivery frequency (INP=460/737, 62%; PGD=348/593, 59%; p=0.16). However, PGD users required additional medication delivery support from other healthcare professionals more often than INP (INP=419/460, 91%; PGD=240/348, 69%; p Discussion Sexual health nurses require independent access to medication for their roles. INP are more likely to practice autonomously, but may spend longer with Patients.
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p119 a comparison of the clinical safety of independent nurse prescribing inp and use of Patient Group Directions pgds by nurses in uk sexual health clinics
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Under UK legislation, nurses independently prescribe or supply medications using PGDs, but evidence on safety in clinical practice is limited. Methods Clinical record review across five UK sexual health services, July–December 2015. Sample size quota stratified based on the number of INP/PGD practising nurses. Documented Patient presentations, diagnoses, autonomy and safety/appropriateness of medication delivery were compared between INP and PGDs. Results From 1,851 (INP=711, 38%; PGD=1,140, 62%) clinical records, 50% (n=933) involved medication delivery. INP delivered medication more frequently (INP= 385/711, 54% vs. PGD=548/1,140, 48%; p=0.01). A total of 879 medication assessments were undertaken (INP=399, PGD=480), 69% (n=609/879) were ‘new’ care episodes. Past medical history, concurrent medications and allergy risk assessments were recorded >85% (n=755/879) of cases. INP managed more symptomatic presentations (n=181/399, 45%: asymptomatic n=121/399, 30%); PGD managed marginally more asymptomatic (n=221/480, 46%; symptomatic n=200/480, 42%). INP worked more autonomously than PGDs (INP=310/399, 78%; PGD=308/480, 64%, p Discussion INP deliver medications more frequently and work more autonomously than PGD users. Both Groups were comparable in safe/appropriate medication delivery. Improved documentation is recommended.
Bryony Dean Franklin - One of the best experts on this subject based on the ideXlab platform.
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a comparison between independent nurse prescribing and Patient Group Directions in the safety and appropriateness of medication provision in united kingdom sexual health services a mixed methods study
International Journal of Nursing Studies, 2020Co-Authors: Adam Black, Heather Gage, Christine Norton, Bryony Dean Franklin, Trevor Murrells, Molly CourtenayAbstract:Abstract Background United Kingdom legislation allows nurses to autonomously provide medications as independent nurse prescribers or using Patient Group Directions. Evidence of medication safety and appropriateness is limited. We compared nurse prescribers and Patient Group direction users in terms of prevalence, types and severity of medication provision errors. Methods Objectives: Compare safety and appropriateness of medication provision between nurse prescribers and Patient Group direction users. Design: Mixed methods clinical notes review and nurse-Patient consultation observations. Setting Five United Kingdom sexual health services. Selection criteria ‘Clinical notes review’ included a random selection of nurse-Patient consultations July-December 2015, 743 consultations managed by nurse prescribers and 939 consultations by Patient Group direction users. ‘Observation study’ involved 15 nurse prescriber and 15 Patient Group direction user nurse-Patient medication consultations. Patients aged under 16 or non-English speaking were excluded. Measurements Medication safety/appropriateness was compared between nurse prescribers and Patient Group direction users. Medication provision errors were categorised and assigned severity ratings. The Medication Appropriateness Index and the Prescribing Framework were used to assess medication provision. Results Of 1682 clinical notes (nurse prescribers=743, 44%; Patient Group Directions=939, 56%), 879 involved the provision of 1357 medications (nurse prescribers=399, 54%; Patient Group Directions=480, 51%). The overall error rate was 8.5% (1844 errors from a potential 21,738 errors), predominantly related to documentation omissions. Nurse prescribers were more likely to make an error compared to Patient Group Directions users (error rates 9% versus 8%, respectively; p=0.001); most were ‘minor’ (nurse prescribers=489, 56%; Patient Group Directions=602, 62%). Both nurse prescribers and Patient Group direction users made safe medication decisions (n=1640 of 1682 Patient care episodes, 98%); however, Patient Group Directions users worked outside Patient Group Directions restrictions in 39 (8%) of consultations. In 101 consultations, medication was indicated but not documented as offered/provided. From 30 observed consultations assessed against the Prescribing Framework, nurse prescribers’ and Patient Group Directions users’ clinical practice were comparable (maximum score 46: nurse prescribers=44.7; Patient Group direction=45.4, p=0.41). Conclusion Sexual health nurse prescribers and Patient Group direction users provided safe and therapeutically appropriate medication. Improvements in clinical documentation are recommended. Moreover, Patient Group Directions users should be encouraged to adhere to Patient Group Directions’ governance restrictions, such as through regular training, audits and staff updates.
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A comparison between independent nurse prescribing and Patient Group Directions in the safety and appropriateness of medication provision in United Kingdom sexual health services: A mixed methods study.
International Journal of Nursing Studies, 2020Co-Authors: Adam Black, Heather Gage, Christine Norton, Bryony Dean Franklin, Trevor Murrells, Molly CourtenayAbstract:Abstract Background : United Kingdom legislation allows nurses to autonomously provide medications as independent nurse prescribers or using Patient Group Directions. Evidence of medication safety and appropriateness is limited. We compared nurse prescribers and Patient Group direction users in terms of prevalence, types and severity of medication provision errors. Methods : Objectives: Compare safety and appropriateness of medication provision between nurse prescribers and Patient Group direction users Design: Mixed methods: clinical notes review and nurse-Patient consultation observations. Setting: Five United Kingdom sexual health services. Selection criteria: ‘Clinical notes review’ included a random selection of nurse-Patient consultations July-December 2015, 743 consutlations managed by nurse prescribers and 939 consultations by Patient Group direction users. ‘Observation study’ involved 15 nurse prescriber and 15 Patient Group direction user nurse-Patient medication consultations. Patients aged under 16 or non-English speaking were excluded. Measurements: Medication safety/appropriateness was compared between nurse prescribers and Patient Group direction users. Medication provision errors were categorised and assigned severity ratings. The Medication Appropriateness Index and the Prescribing Framework were used to assess medication provision. Results : Of 1,682 clinical notes (nurse prescribers=743, 44%; Patient Group Directions=939, 56%), 879 involved the provision of 1,357 medications (nurse prescribers=399, 54%; Patient Group Directions=480, 51%). The overall error rate was 8.5% (1,844 errors from a potential 21,738 errors), predominantly related to documentation omissions. Nurse prescribers were more likely to make an error compared to Patient Group Directions users (error rates 9% versus 8%, respectively; p=0.001); most were ‘minor’ (nurse prescribers=489, 56%; Patient Group Directions=602, 62%). Both nurse prescribers and Patient Group direction users made safe medication decisions (n=1,640 of 1,682 Patient care episodes, 98%); however, Patient Group Directions users worked outside Patient Group Directions restrictions in 39 (8%) of consultations. In 101 consultations, medication was indicated but not documented as offered/provided. From 30 observed consultations assessed against the Prescribing Framework, nurse prescribers’ and Patient Group Directions users’ clinical practice were comparable (maximum score 46: nurse prescribers=44.7; Patient Group direction=45.4, p=0.41). Conclusion : Sexual health nurse prescribers and Patient Group direction users provided safe and therapeutically appropriate medication. Improvements in clinical documentation are recommended. Moreover, Patient Group Directions users should be encouraged to adhere to Patient Group Directions’ governance restrictions, such as through regular training, audits and staff updates. Contribution of paper What is already known about the topic?
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p118 Patients satisfaction with medication information provided by nurses using independent nurse prescribing inp or Patient Group Directions pgds in uk sexual health services
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Nurses’ ability to independently deliver medication was introduced to improve Patients’ access to medication and experience of healthcare services. INP and PGDs are used frequently in sexual health services; however, there is limited evidence of Patients’ satisfaction with medication information provided. Methods Nurses (INP or using PGD) from five UK sexual health services distributed a questionnaire to Patients with whom they had consulted and delivered medication, Sept 2015 – Aug 2016. The questionnaire was informed by Birmingham’s sexual health service satisfaction questionnaire and the Satisfaction with Information about Medicines Scale (SIMS). Results Of the 393 Patients who received a questionnaire, 92% (n=360) responded. Patients who had received medicines via a PGD and INP reported nurses to be friendly and approachable (n=359/360, 99%); that they installed confidence and trust (n=357/360, 99%); explained the reasons for medications clearly (n=349/360, 97%); and suitably answered questions (n=335/360, 93%). Of the 89% (n=348/360) of respondents who completed the SIMS, an overall score of 13.3/16 was achieved: the higher the score, the greater the satisfaction. The largest points of dissatisfaction related to not receiving information on whether they could drink alcohol (n=58/348, 17%), potential for drowsiness (n=54/348, 16%) or side effects (n=37/348, 11%). Discussion Patients predominantly provided positive feedback regarding their medication consultations with nurses. High SIMS scores identified overall satisfaction with medication information. Further consideration may be needed on the potential problems medications can cause to further improve Patient satisfaction (e.g. advice on alcohol consumption, side effects and drowsiness potential).
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p130 a comparison of demographic characteristics and workloads of independent nurse prescribers inp and nurses using Patient Group Directions pgds in sexual health clinics
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Nurses legally deliver medication independently using INP or PGDs. Despite growing evidence of clinical application, there is limited sexual health research. Methods INP and PGD nurses from five UK sexual health services completed a questionnaire, and recorded two weeks of clinical activity in a specifically designed diary, Aug 2015–Aug 2016. Results Questionnaire response rate: 64% (61/95; INP=26/28, 93%; PGD=35/67, 52%). Respondents were mostly female (n=55/61, 90%), aged 35–44years (n=21/61, 34%). INP were mainly Band 7 or above (n=18/26, 69%), educated to Masters Level (n=16/26, 62%); PGD users were mostly Band 6 (n=24/35, 68.6%), educated to Diploma Level (n=13/35, 37%). INP had mean of 2.9 years more sexual health experience than PGD users (mean: INP=13.0; PGD=10.1years). Both Groups reported access to medications was essential (n=56/61, 92%) and made their roles easier (n=60/61, 98%). Overall 61% (INP=17/26, 65%; PGD=20/35, 57%) of questionnaire respondents completed the diary. Of the total diary entries (INP=737; PGD=593), INP managed more ‘new’ care episodes (n=512/737, 70%) than PGD users (n=294/593, 50%). There was no difference in medication delivery frequency (INP=460/737, 62%; PGD=348/593, 59%; p=0.16). However, PGD users required additional medication delivery support from other healthcare professionals more often than INP (INP=419/460, 91%; PGD=240/348, 69%; p Discussion Sexual health nurses require independent access to medication for their roles. INP are more likely to practice autonomously, but may spend longer with Patients.
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p119 a comparison of the clinical safety of independent nurse prescribing inp and use of Patient Group Directions pgds by nurses in uk sexual health clinics
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Under UK legislation, nurses independently prescribe or supply medications using PGDs, but evidence on safety in clinical practice is limited. Methods Clinical record review across five UK sexual health services, July–December 2015. Sample size quota stratified based on the number of INP/PGD practising nurses. Documented Patient presentations, diagnoses, autonomy and safety/appropriateness of medication delivery were compared between INP and PGDs. Results From 1,851 (INP=711, 38%; PGD=1,140, 62%) clinical records, 50% (n=933) involved medication delivery. INP delivered medication more frequently (INP= 385/711, 54% vs. PGD=548/1,140, 48%; p=0.01). A total of 879 medication assessments were undertaken (INP=399, PGD=480), 69% (n=609/879) were ‘new’ care episodes. Past medical history, concurrent medications and allergy risk assessments were recorded >85% (n=755/879) of cases. INP managed more symptomatic presentations (n=181/399, 45%: asymptomatic n=121/399, 30%); PGD managed marginally more asymptomatic (n=221/480, 46%; symptomatic n=200/480, 42%). INP worked more autonomously than PGDs (INP=310/399, 78%; PGD=308/480, 64%, p Discussion INP deliver medications more frequently and work more autonomously than PGD users. Both Groups were comparable in safe/appropriate medication delivery. Improved documentation is recommended.
Molly Courtenay - One of the best experts on this subject based on the ideXlab platform.
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a comparison between independent nurse prescribing and Patient Group Directions in the safety and appropriateness of medication provision in united kingdom sexual health services a mixed methods study
International Journal of Nursing Studies, 2020Co-Authors: Adam Black, Heather Gage, Christine Norton, Bryony Dean Franklin, Trevor Murrells, Molly CourtenayAbstract:Abstract Background United Kingdom legislation allows nurses to autonomously provide medications as independent nurse prescribers or using Patient Group Directions. Evidence of medication safety and appropriateness is limited. We compared nurse prescribers and Patient Group direction users in terms of prevalence, types and severity of medication provision errors. Methods Objectives: Compare safety and appropriateness of medication provision between nurse prescribers and Patient Group direction users. Design: Mixed methods clinical notes review and nurse-Patient consultation observations. Setting Five United Kingdom sexual health services. Selection criteria ‘Clinical notes review’ included a random selection of nurse-Patient consultations July-December 2015, 743 consultations managed by nurse prescribers and 939 consultations by Patient Group direction users. ‘Observation study’ involved 15 nurse prescriber and 15 Patient Group direction user nurse-Patient medication consultations. Patients aged under 16 or non-English speaking were excluded. Measurements Medication safety/appropriateness was compared between nurse prescribers and Patient Group direction users. Medication provision errors were categorised and assigned severity ratings. The Medication Appropriateness Index and the Prescribing Framework were used to assess medication provision. Results Of 1682 clinical notes (nurse prescribers=743, 44%; Patient Group Directions=939, 56%), 879 involved the provision of 1357 medications (nurse prescribers=399, 54%; Patient Group Directions=480, 51%). The overall error rate was 8.5% (1844 errors from a potential 21,738 errors), predominantly related to documentation omissions. Nurse prescribers were more likely to make an error compared to Patient Group Directions users (error rates 9% versus 8%, respectively; p=0.001); most were ‘minor’ (nurse prescribers=489, 56%; Patient Group Directions=602, 62%). Both nurse prescribers and Patient Group direction users made safe medication decisions (n=1640 of 1682 Patient care episodes, 98%); however, Patient Group Directions users worked outside Patient Group Directions restrictions in 39 (8%) of consultations. In 101 consultations, medication was indicated but not documented as offered/provided. From 30 observed consultations assessed against the Prescribing Framework, nurse prescribers’ and Patient Group Directions users’ clinical practice were comparable (maximum score 46: nurse prescribers=44.7; Patient Group direction=45.4, p=0.41). Conclusion Sexual health nurse prescribers and Patient Group direction users provided safe and therapeutically appropriate medication. Improvements in clinical documentation are recommended. Moreover, Patient Group Directions users should be encouraged to adhere to Patient Group Directions’ governance restrictions, such as through regular training, audits and staff updates.
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A comparison between independent nurse prescribing and Patient Group Directions in the safety and appropriateness of medication provision in United Kingdom sexual health services: A mixed methods study.
International Journal of Nursing Studies, 2020Co-Authors: Adam Black, Heather Gage, Christine Norton, Bryony Dean Franklin, Trevor Murrells, Molly CourtenayAbstract:Abstract Background : United Kingdom legislation allows nurses to autonomously provide medications as independent nurse prescribers or using Patient Group Directions. Evidence of medication safety and appropriateness is limited. We compared nurse prescribers and Patient Group direction users in terms of prevalence, types and severity of medication provision errors. Methods : Objectives: Compare safety and appropriateness of medication provision between nurse prescribers and Patient Group direction users Design: Mixed methods: clinical notes review and nurse-Patient consultation observations. Setting: Five United Kingdom sexual health services. Selection criteria: ‘Clinical notes review’ included a random selection of nurse-Patient consultations July-December 2015, 743 consutlations managed by nurse prescribers and 939 consultations by Patient Group direction users. ‘Observation study’ involved 15 nurse prescriber and 15 Patient Group direction user nurse-Patient medication consultations. Patients aged under 16 or non-English speaking were excluded. Measurements: Medication safety/appropriateness was compared between nurse prescribers and Patient Group direction users. Medication provision errors were categorised and assigned severity ratings. The Medication Appropriateness Index and the Prescribing Framework were used to assess medication provision. Results : Of 1,682 clinical notes (nurse prescribers=743, 44%; Patient Group Directions=939, 56%), 879 involved the provision of 1,357 medications (nurse prescribers=399, 54%; Patient Group Directions=480, 51%). The overall error rate was 8.5% (1,844 errors from a potential 21,738 errors), predominantly related to documentation omissions. Nurse prescribers were more likely to make an error compared to Patient Group Directions users (error rates 9% versus 8%, respectively; p=0.001); most were ‘minor’ (nurse prescribers=489, 56%; Patient Group Directions=602, 62%). Both nurse prescribers and Patient Group direction users made safe medication decisions (n=1,640 of 1,682 Patient care episodes, 98%); however, Patient Group Directions users worked outside Patient Group Directions restrictions in 39 (8%) of consultations. In 101 consultations, medication was indicated but not documented as offered/provided. From 30 observed consultations assessed against the Prescribing Framework, nurse prescribers’ and Patient Group Directions users’ clinical practice were comparable (maximum score 46: nurse prescribers=44.7; Patient Group direction=45.4, p=0.41). Conclusion : Sexual health nurse prescribers and Patient Group direction users provided safe and therapeutically appropriate medication. Improvements in clinical documentation are recommended. Moreover, Patient Group Directions users should be encouraged to adhere to Patient Group Directions’ governance restrictions, such as through regular training, audits and staff updates. Contribution of paper What is already known about the topic?
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p118 Patients satisfaction with medication information provided by nurses using independent nurse prescribing inp or Patient Group Directions pgds in uk sexual health services
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Nurses’ ability to independently deliver medication was introduced to improve Patients’ access to medication and experience of healthcare services. INP and PGDs are used frequently in sexual health services; however, there is limited evidence of Patients’ satisfaction with medication information provided. Methods Nurses (INP or using PGD) from five UK sexual health services distributed a questionnaire to Patients with whom they had consulted and delivered medication, Sept 2015 – Aug 2016. The questionnaire was informed by Birmingham’s sexual health service satisfaction questionnaire and the Satisfaction with Information about Medicines Scale (SIMS). Results Of the 393 Patients who received a questionnaire, 92% (n=360) responded. Patients who had received medicines via a PGD and INP reported nurses to be friendly and approachable (n=359/360, 99%); that they installed confidence and trust (n=357/360, 99%); explained the reasons for medications clearly (n=349/360, 97%); and suitably answered questions (n=335/360, 93%). Of the 89% (n=348/360) of respondents who completed the SIMS, an overall score of 13.3/16 was achieved: the higher the score, the greater the satisfaction. The largest points of dissatisfaction related to not receiving information on whether they could drink alcohol (n=58/348, 17%), potential for drowsiness (n=54/348, 16%) or side effects (n=37/348, 11%). Discussion Patients predominantly provided positive feedback regarding their medication consultations with nurses. High SIMS scores identified overall satisfaction with medication information. Further consideration may be needed on the potential problems medications can cause to further improve Patient satisfaction (e.g. advice on alcohol consumption, side effects and drowsiness potential).
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p130 a comparison of demographic characteristics and workloads of independent nurse prescribers inp and nurses using Patient Group Directions pgds in sexual health clinics
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Nurses legally deliver medication independently using INP or PGDs. Despite growing evidence of clinical application, there is limited sexual health research. Methods INP and PGD nurses from five UK sexual health services completed a questionnaire, and recorded two weeks of clinical activity in a specifically designed diary, Aug 2015–Aug 2016. Results Questionnaire response rate: 64% (61/95; INP=26/28, 93%; PGD=35/67, 52%). Respondents were mostly female (n=55/61, 90%), aged 35–44years (n=21/61, 34%). INP were mainly Band 7 or above (n=18/26, 69%), educated to Masters Level (n=16/26, 62%); PGD users were mostly Band 6 (n=24/35, 68.6%), educated to Diploma Level (n=13/35, 37%). INP had mean of 2.9 years more sexual health experience than PGD users (mean: INP=13.0; PGD=10.1years). Both Groups reported access to medications was essential (n=56/61, 92%) and made their roles easier (n=60/61, 98%). Overall 61% (INP=17/26, 65%; PGD=20/35, 57%) of questionnaire respondents completed the diary. Of the total diary entries (INP=737; PGD=593), INP managed more ‘new’ care episodes (n=512/737, 70%) than PGD users (n=294/593, 50%). There was no difference in medication delivery frequency (INP=460/737, 62%; PGD=348/593, 59%; p=0.16). However, PGD users required additional medication delivery support from other healthcare professionals more often than INP (INP=419/460, 91%; PGD=240/348, 69%; p Discussion Sexual health nurses require independent access to medication for their roles. INP are more likely to practice autonomously, but may spend longer with Patients.
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p119 a comparison of the clinical safety of independent nurse prescribing inp and use of Patient Group Directions pgds by nurses in uk sexual health clinics
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Under UK legislation, nurses independently prescribe or supply medications using PGDs, but evidence on safety in clinical practice is limited. Methods Clinical record review across five UK sexual health services, July–December 2015. Sample size quota stratified based on the number of INP/PGD practising nurses. Documented Patient presentations, diagnoses, autonomy and safety/appropriateness of medication delivery were compared between INP and PGDs. Results From 1,851 (INP=711, 38%; PGD=1,140, 62%) clinical records, 50% (n=933) involved medication delivery. INP delivered medication more frequently (INP= 385/711, 54% vs. PGD=548/1,140, 48%; p=0.01). A total of 879 medication assessments were undertaken (INP=399, PGD=480), 69% (n=609/879) were ‘new’ care episodes. Past medical history, concurrent medications and allergy risk assessments were recorded >85% (n=755/879) of cases. INP managed more symptomatic presentations (n=181/399, 45%: asymptomatic n=121/399, 30%); PGD managed marginally more asymptomatic (n=221/480, 46%; symptomatic n=200/480, 42%). INP worked more autonomously than PGDs (INP=310/399, 78%; PGD=308/480, 64%, p Discussion INP deliver medications more frequently and work more autonomously than PGD users. Both Groups were comparable in safe/appropriate medication delivery. Improved documentation is recommended.
Christine Norton - One of the best experts on this subject based on the ideXlab platform.
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a comparison between independent nurse prescribing and Patient Group Directions in the safety and appropriateness of medication provision in united kingdom sexual health services a mixed methods study
International Journal of Nursing Studies, 2020Co-Authors: Adam Black, Heather Gage, Christine Norton, Bryony Dean Franklin, Trevor Murrells, Molly CourtenayAbstract:Abstract Background United Kingdom legislation allows nurses to autonomously provide medications as independent nurse prescribers or using Patient Group Directions. Evidence of medication safety and appropriateness is limited. We compared nurse prescribers and Patient Group direction users in terms of prevalence, types and severity of medication provision errors. Methods Objectives: Compare safety and appropriateness of medication provision between nurse prescribers and Patient Group direction users. Design: Mixed methods clinical notes review and nurse-Patient consultation observations. Setting Five United Kingdom sexual health services. Selection criteria ‘Clinical notes review’ included a random selection of nurse-Patient consultations July-December 2015, 743 consultations managed by nurse prescribers and 939 consultations by Patient Group direction users. ‘Observation study’ involved 15 nurse prescriber and 15 Patient Group direction user nurse-Patient medication consultations. Patients aged under 16 or non-English speaking were excluded. Measurements Medication safety/appropriateness was compared between nurse prescribers and Patient Group direction users. Medication provision errors were categorised and assigned severity ratings. The Medication Appropriateness Index and the Prescribing Framework were used to assess medication provision. Results Of 1682 clinical notes (nurse prescribers=743, 44%; Patient Group Directions=939, 56%), 879 involved the provision of 1357 medications (nurse prescribers=399, 54%; Patient Group Directions=480, 51%). The overall error rate was 8.5% (1844 errors from a potential 21,738 errors), predominantly related to documentation omissions. Nurse prescribers were more likely to make an error compared to Patient Group Directions users (error rates 9% versus 8%, respectively; p=0.001); most were ‘minor’ (nurse prescribers=489, 56%; Patient Group Directions=602, 62%). Both nurse prescribers and Patient Group direction users made safe medication decisions (n=1640 of 1682 Patient care episodes, 98%); however, Patient Group Directions users worked outside Patient Group Directions restrictions in 39 (8%) of consultations. In 101 consultations, medication was indicated but not documented as offered/provided. From 30 observed consultations assessed against the Prescribing Framework, nurse prescribers’ and Patient Group Directions users’ clinical practice were comparable (maximum score 46: nurse prescribers=44.7; Patient Group direction=45.4, p=0.41). Conclusion Sexual health nurse prescribers and Patient Group direction users provided safe and therapeutically appropriate medication. Improvements in clinical documentation are recommended. Moreover, Patient Group Directions users should be encouraged to adhere to Patient Group Directions’ governance restrictions, such as through regular training, audits and staff updates.
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A comparison between independent nurse prescribing and Patient Group Directions in the safety and appropriateness of medication provision in United Kingdom sexual health services: A mixed methods study.
International Journal of Nursing Studies, 2020Co-Authors: Adam Black, Heather Gage, Christine Norton, Bryony Dean Franklin, Trevor Murrells, Molly CourtenayAbstract:Abstract Background : United Kingdom legislation allows nurses to autonomously provide medications as independent nurse prescribers or using Patient Group Directions. Evidence of medication safety and appropriateness is limited. We compared nurse prescribers and Patient Group direction users in terms of prevalence, types and severity of medication provision errors. Methods : Objectives: Compare safety and appropriateness of medication provision between nurse prescribers and Patient Group direction users Design: Mixed methods: clinical notes review and nurse-Patient consultation observations. Setting: Five United Kingdom sexual health services. Selection criteria: ‘Clinical notes review’ included a random selection of nurse-Patient consultations July-December 2015, 743 consutlations managed by nurse prescribers and 939 consultations by Patient Group direction users. ‘Observation study’ involved 15 nurse prescriber and 15 Patient Group direction user nurse-Patient medication consultations. Patients aged under 16 or non-English speaking were excluded. Measurements: Medication safety/appropriateness was compared between nurse prescribers and Patient Group direction users. Medication provision errors were categorised and assigned severity ratings. The Medication Appropriateness Index and the Prescribing Framework were used to assess medication provision. Results : Of 1,682 clinical notes (nurse prescribers=743, 44%; Patient Group Directions=939, 56%), 879 involved the provision of 1,357 medications (nurse prescribers=399, 54%; Patient Group Directions=480, 51%). The overall error rate was 8.5% (1,844 errors from a potential 21,738 errors), predominantly related to documentation omissions. Nurse prescribers were more likely to make an error compared to Patient Group Directions users (error rates 9% versus 8%, respectively; p=0.001); most were ‘minor’ (nurse prescribers=489, 56%; Patient Group Directions=602, 62%). Both nurse prescribers and Patient Group direction users made safe medication decisions (n=1,640 of 1,682 Patient care episodes, 98%); however, Patient Group Directions users worked outside Patient Group Directions restrictions in 39 (8%) of consultations. In 101 consultations, medication was indicated but not documented as offered/provided. From 30 observed consultations assessed against the Prescribing Framework, nurse prescribers’ and Patient Group Directions users’ clinical practice were comparable (maximum score 46: nurse prescribers=44.7; Patient Group direction=45.4, p=0.41). Conclusion : Sexual health nurse prescribers and Patient Group direction users provided safe and therapeutically appropriate medication. Improvements in clinical documentation are recommended. Moreover, Patient Group Directions users should be encouraged to adhere to Patient Group Directions’ governance restrictions, such as through regular training, audits and staff updates. Contribution of paper What is already known about the topic?
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p118 Patients satisfaction with medication information provided by nurses using independent nurse prescribing inp or Patient Group Directions pgds in uk sexual health services
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Nurses’ ability to independently deliver medication was introduced to improve Patients’ access to medication and experience of healthcare services. INP and PGDs are used frequently in sexual health services; however, there is limited evidence of Patients’ satisfaction with medication information provided. Methods Nurses (INP or using PGD) from five UK sexual health services distributed a questionnaire to Patients with whom they had consulted and delivered medication, Sept 2015 – Aug 2016. The questionnaire was informed by Birmingham’s sexual health service satisfaction questionnaire and the Satisfaction with Information about Medicines Scale (SIMS). Results Of the 393 Patients who received a questionnaire, 92% (n=360) responded. Patients who had received medicines via a PGD and INP reported nurses to be friendly and approachable (n=359/360, 99%); that they installed confidence and trust (n=357/360, 99%); explained the reasons for medications clearly (n=349/360, 97%); and suitably answered questions (n=335/360, 93%). Of the 89% (n=348/360) of respondents who completed the SIMS, an overall score of 13.3/16 was achieved: the higher the score, the greater the satisfaction. The largest points of dissatisfaction related to not receiving information on whether they could drink alcohol (n=58/348, 17%), potential for drowsiness (n=54/348, 16%) or side effects (n=37/348, 11%). Discussion Patients predominantly provided positive feedback regarding their medication consultations with nurses. High SIMS scores identified overall satisfaction with medication information. Further consideration may be needed on the potential problems medications can cause to further improve Patient satisfaction (e.g. advice on alcohol consumption, side effects and drowsiness potential).
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p130 a comparison of demographic characteristics and workloads of independent nurse prescribers inp and nurses using Patient Group Directions pgds in sexual health clinics
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Nurses legally deliver medication independently using INP or PGDs. Despite growing evidence of clinical application, there is limited sexual health research. Methods INP and PGD nurses from five UK sexual health services completed a questionnaire, and recorded two weeks of clinical activity in a specifically designed diary, Aug 2015–Aug 2016. Results Questionnaire response rate: 64% (61/95; INP=26/28, 93%; PGD=35/67, 52%). Respondents were mostly female (n=55/61, 90%), aged 35–44years (n=21/61, 34%). INP were mainly Band 7 or above (n=18/26, 69%), educated to Masters Level (n=16/26, 62%); PGD users were mostly Band 6 (n=24/35, 68.6%), educated to Diploma Level (n=13/35, 37%). INP had mean of 2.9 years more sexual health experience than PGD users (mean: INP=13.0; PGD=10.1years). Both Groups reported access to medications was essential (n=56/61, 92%) and made their roles easier (n=60/61, 98%). Overall 61% (INP=17/26, 65%; PGD=20/35, 57%) of questionnaire respondents completed the diary. Of the total diary entries (INP=737; PGD=593), INP managed more ‘new’ care episodes (n=512/737, 70%) than PGD users (n=294/593, 50%). There was no difference in medication delivery frequency (INP=460/737, 62%; PGD=348/593, 59%; p=0.16). However, PGD users required additional medication delivery support from other healthcare professionals more often than INP (INP=419/460, 91%; PGD=240/348, 69%; p Discussion Sexual health nurses require independent access to medication for their roles. INP are more likely to practice autonomously, but may spend longer with Patients.
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p119 a comparison of the clinical safety of independent nurse prescribing inp and use of Patient Group Directions pgds by nurses in uk sexual health clinics
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Under UK legislation, nurses independently prescribe or supply medications using PGDs, but evidence on safety in clinical practice is limited. Methods Clinical record review across five UK sexual health services, July–December 2015. Sample size quota stratified based on the number of INP/PGD practising nurses. Documented Patient presentations, diagnoses, autonomy and safety/appropriateness of medication delivery were compared between INP and PGDs. Results From 1,851 (INP=711, 38%; PGD=1,140, 62%) clinical records, 50% (n=933) involved medication delivery. INP delivered medication more frequently (INP= 385/711, 54% vs. PGD=548/1,140, 48%; p=0.01). A total of 879 medication assessments were undertaken (INP=399, PGD=480), 69% (n=609/879) were ‘new’ care episodes. Past medical history, concurrent medications and allergy risk assessments were recorded >85% (n=755/879) of cases. INP managed more symptomatic presentations (n=181/399, 45%: asymptomatic n=121/399, 30%); PGD managed marginally more asymptomatic (n=221/480, 46%; symptomatic n=200/480, 42%). INP worked more autonomously than PGDs (INP=310/399, 78%; PGD=308/480, 64%, p Discussion INP deliver medications more frequently and work more autonomously than PGD users. Both Groups were comparable in safe/appropriate medication delivery. Improved documentation is recommended.
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a comparison between independent nurse prescribing and Patient Group Directions in the safety and appropriateness of medication provision in united kingdom sexual health services a mixed methods study
International Journal of Nursing Studies, 2020Co-Authors: Adam Black, Heather Gage, Christine Norton, Bryony Dean Franklin, Trevor Murrells, Molly CourtenayAbstract:Abstract Background United Kingdom legislation allows nurses to autonomously provide medications as independent nurse prescribers or using Patient Group Directions. Evidence of medication safety and appropriateness is limited. We compared nurse prescribers and Patient Group direction users in terms of prevalence, types and severity of medication provision errors. Methods Objectives: Compare safety and appropriateness of medication provision between nurse prescribers and Patient Group direction users. Design: Mixed methods clinical notes review and nurse-Patient consultation observations. Setting Five United Kingdom sexual health services. Selection criteria ‘Clinical notes review’ included a random selection of nurse-Patient consultations July-December 2015, 743 consultations managed by nurse prescribers and 939 consultations by Patient Group direction users. ‘Observation study’ involved 15 nurse prescriber and 15 Patient Group direction user nurse-Patient medication consultations. Patients aged under 16 or non-English speaking were excluded. Measurements Medication safety/appropriateness was compared between nurse prescribers and Patient Group direction users. Medication provision errors were categorised and assigned severity ratings. The Medication Appropriateness Index and the Prescribing Framework were used to assess medication provision. Results Of 1682 clinical notes (nurse prescribers=743, 44%; Patient Group Directions=939, 56%), 879 involved the provision of 1357 medications (nurse prescribers=399, 54%; Patient Group Directions=480, 51%). The overall error rate was 8.5% (1844 errors from a potential 21,738 errors), predominantly related to documentation omissions. Nurse prescribers were more likely to make an error compared to Patient Group Directions users (error rates 9% versus 8%, respectively; p=0.001); most were ‘minor’ (nurse prescribers=489, 56%; Patient Group Directions=602, 62%). Both nurse prescribers and Patient Group direction users made safe medication decisions (n=1640 of 1682 Patient care episodes, 98%); however, Patient Group Directions users worked outside Patient Group Directions restrictions in 39 (8%) of consultations. In 101 consultations, medication was indicated but not documented as offered/provided. From 30 observed consultations assessed against the Prescribing Framework, nurse prescribers’ and Patient Group Directions users’ clinical practice were comparable (maximum score 46: nurse prescribers=44.7; Patient Group direction=45.4, p=0.41). Conclusion Sexual health nurse prescribers and Patient Group direction users provided safe and therapeutically appropriate medication. Improvements in clinical documentation are recommended. Moreover, Patient Group Directions users should be encouraged to adhere to Patient Group Directions’ governance restrictions, such as through regular training, audits and staff updates.
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A comparison between independent nurse prescribing and Patient Group Directions in the safety and appropriateness of medication provision in United Kingdom sexual health services: A mixed methods study.
International Journal of Nursing Studies, 2020Co-Authors: Adam Black, Heather Gage, Christine Norton, Bryony Dean Franklin, Trevor Murrells, Molly CourtenayAbstract:Abstract Background : United Kingdom legislation allows nurses to autonomously provide medications as independent nurse prescribers or using Patient Group Directions. Evidence of medication safety and appropriateness is limited. We compared nurse prescribers and Patient Group direction users in terms of prevalence, types and severity of medication provision errors. Methods : Objectives: Compare safety and appropriateness of medication provision between nurse prescribers and Patient Group direction users Design: Mixed methods: clinical notes review and nurse-Patient consultation observations. Setting: Five United Kingdom sexual health services. Selection criteria: ‘Clinical notes review’ included a random selection of nurse-Patient consultations July-December 2015, 743 consutlations managed by nurse prescribers and 939 consultations by Patient Group direction users. ‘Observation study’ involved 15 nurse prescriber and 15 Patient Group direction user nurse-Patient medication consultations. Patients aged under 16 or non-English speaking were excluded. Measurements: Medication safety/appropriateness was compared between nurse prescribers and Patient Group direction users. Medication provision errors were categorised and assigned severity ratings. The Medication Appropriateness Index and the Prescribing Framework were used to assess medication provision. Results : Of 1,682 clinical notes (nurse prescribers=743, 44%; Patient Group Directions=939, 56%), 879 involved the provision of 1,357 medications (nurse prescribers=399, 54%; Patient Group Directions=480, 51%). The overall error rate was 8.5% (1,844 errors from a potential 21,738 errors), predominantly related to documentation omissions. Nurse prescribers were more likely to make an error compared to Patient Group Directions users (error rates 9% versus 8%, respectively; p=0.001); most were ‘minor’ (nurse prescribers=489, 56%; Patient Group Directions=602, 62%). Both nurse prescribers and Patient Group direction users made safe medication decisions (n=1,640 of 1,682 Patient care episodes, 98%); however, Patient Group Directions users worked outside Patient Group Directions restrictions in 39 (8%) of consultations. In 101 consultations, medication was indicated but not documented as offered/provided. From 30 observed consultations assessed against the Prescribing Framework, nurse prescribers’ and Patient Group Directions users’ clinical practice were comparable (maximum score 46: nurse prescribers=44.7; Patient Group direction=45.4, p=0.41). Conclusion : Sexual health nurse prescribers and Patient Group direction users provided safe and therapeutically appropriate medication. Improvements in clinical documentation are recommended. Moreover, Patient Group Directions users should be encouraged to adhere to Patient Group Directions’ governance restrictions, such as through regular training, audits and staff updates. Contribution of paper What is already known about the topic?
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p118 Patients satisfaction with medication information provided by nurses using independent nurse prescribing inp or Patient Group Directions pgds in uk sexual health services
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Nurses’ ability to independently deliver medication was introduced to improve Patients’ access to medication and experience of healthcare services. INP and PGDs are used frequently in sexual health services; however, there is limited evidence of Patients’ satisfaction with medication information provided. Methods Nurses (INP or using PGD) from five UK sexual health services distributed a questionnaire to Patients with whom they had consulted and delivered medication, Sept 2015 – Aug 2016. The questionnaire was informed by Birmingham’s sexual health service satisfaction questionnaire and the Satisfaction with Information about Medicines Scale (SIMS). Results Of the 393 Patients who received a questionnaire, 92% (n=360) responded. Patients who had received medicines via a PGD and INP reported nurses to be friendly and approachable (n=359/360, 99%); that they installed confidence and trust (n=357/360, 99%); explained the reasons for medications clearly (n=349/360, 97%); and suitably answered questions (n=335/360, 93%). Of the 89% (n=348/360) of respondents who completed the SIMS, an overall score of 13.3/16 was achieved: the higher the score, the greater the satisfaction. The largest points of dissatisfaction related to not receiving information on whether they could drink alcohol (n=58/348, 17%), potential for drowsiness (n=54/348, 16%) or side effects (n=37/348, 11%). Discussion Patients predominantly provided positive feedback regarding their medication consultations with nurses. High SIMS scores identified overall satisfaction with medication information. Further consideration may be needed on the potential problems medications can cause to further improve Patient satisfaction (e.g. advice on alcohol consumption, side effects and drowsiness potential).
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p130 a comparison of demographic characteristics and workloads of independent nurse prescribers inp and nurses using Patient Group Directions pgds in sexual health clinics
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Nurses legally deliver medication independently using INP or PGDs. Despite growing evidence of clinical application, there is limited sexual health research. Methods INP and PGD nurses from five UK sexual health services completed a questionnaire, and recorded two weeks of clinical activity in a specifically designed diary, Aug 2015–Aug 2016. Results Questionnaire response rate: 64% (61/95; INP=26/28, 93%; PGD=35/67, 52%). Respondents were mostly female (n=55/61, 90%), aged 35–44years (n=21/61, 34%). INP were mainly Band 7 or above (n=18/26, 69%), educated to Masters Level (n=16/26, 62%); PGD users were mostly Band 6 (n=24/35, 68.6%), educated to Diploma Level (n=13/35, 37%). INP had mean of 2.9 years more sexual health experience than PGD users (mean: INP=13.0; PGD=10.1years). Both Groups reported access to medications was essential (n=56/61, 92%) and made their roles easier (n=60/61, 98%). Overall 61% (INP=17/26, 65%; PGD=20/35, 57%) of questionnaire respondents completed the diary. Of the total diary entries (INP=737; PGD=593), INP managed more ‘new’ care episodes (n=512/737, 70%) than PGD users (n=294/593, 50%). There was no difference in medication delivery frequency (INP=460/737, 62%; PGD=348/593, 59%; p=0.16). However, PGD users required additional medication delivery support from other healthcare professionals more often than INP (INP=419/460, 91%; PGD=240/348, 69%; p Discussion Sexual health nurses require independent access to medication for their roles. INP are more likely to practice autonomously, but may spend longer with Patients.
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p119 a comparison of the clinical safety of independent nurse prescribing inp and use of Patient Group Directions pgds by nurses in uk sexual health clinics
Sexually Transmitted Infections, 2017Co-Authors: Adam Black, Heather Gage, Christine Norton, Molly Courtenay, Bryony Dean FranklinAbstract:Introduction Under UK legislation, nurses independently prescribe or supply medications using PGDs, but evidence on safety in clinical practice is limited. Methods Clinical record review across five UK sexual health services, July–December 2015. Sample size quota stratified based on the number of INP/PGD practising nurses. Documented Patient presentations, diagnoses, autonomy and safety/appropriateness of medication delivery were compared between INP and PGDs. Results From 1,851 (INP=711, 38%; PGD=1,140, 62%) clinical records, 50% (n=933) involved medication delivery. INP delivered medication more frequently (INP= 385/711, 54% vs. PGD=548/1,140, 48%; p=0.01). A total of 879 medication assessments were undertaken (INP=399, PGD=480), 69% (n=609/879) were ‘new’ care episodes. Past medical history, concurrent medications and allergy risk assessments were recorded >85% (n=755/879) of cases. INP managed more symptomatic presentations (n=181/399, 45%: asymptomatic n=121/399, 30%); PGD managed marginally more asymptomatic (n=221/480, 46%; symptomatic n=200/480, 42%). INP worked more autonomously than PGDs (INP=310/399, 78%; PGD=308/480, 64%, p Discussion INP deliver medications more frequently and work more autonomously than PGD users. Both Groups were comparable in safe/appropriate medication delivery. Improved documentation is recommended.